Informed Consent Form for Audio/Video Recorded Interviews

Project Title:

Principal Investigator:

Institution/Organization:

Purpose of the Interview

Procedures

Confidentiality

Use of Recordings

Voluntary Participation

Participant Rights

You may withdraw from the interview at any time.
You may request the recording to be stopped at any time.
You may refuse to answer any questions.

I have read and understood the information provided above. I consent to participate in this interview and allow the conversation to be audio/video recorded.

Participant Name

Participant Signature

Date

Investigator Name

Investigator Signature

Date